A cervical fracture , commonly called broken neck , is a catastrophic fracture of one of the seven cervical vertebrae in the neck. Examples of common causes in humans are traffic collisions and dives into shallow waters. Abnormal movement of the collar bones or bone fragments can cause spinal cord injury resulting in loss of sensation, paralysis, or usually instant death.
Video Cervical fracture
Cause
It takes great strength to cause cervical fractures. Car and vehicle collisions are a common cause. A severe and abrupt touch to the neck or a hard blow to the head or neck can cause a cervical fracture.
Exercise involving physical contact with violence carries the risk of cervical fractures, including American soccer, Goalkeeper (soccer association), ice hockey, rugby, and wrestling. Cutting an opponent in football or rugby, for example, can cause a broken neck. Cervical fractures can also be seen in some non-contact sports, such as gymnastics, skiing, diving, surfing, powerlifting, equestrianism, mountain biking, and motor racing.
Certain neck injuries can also cause cervical fractures that can also cause internal bleeding among other complications.
Hanging also causes cervical fractures.
Maps Cervical fracture
Diagnosis
Severe pain will usually be present at the point of injury. Pressure on the nerves can also cause pain from the neck to the bottom of the shoulder and/or arm. Bruises and swelling may be on the back of the neck. A neurological exam will be performed to assess a spinal cord injury. X-rays will be instructed to determine the severity and location of the fracture. CT (computed tomography) scans may be ordered to assess gross abnormalities not seen by ordinary X-rays. MRI (magnetic resonance imaging) tests may be ordered to provide high-resolution images of soft tissue and determine if there is damage to the spinal cord, although such damage is usually evident in patients who are aware of the direct functional consequences of numbness and paralysis in most parts of the body.
It is also common for imaging (either ordinary X-ray film or CT scan) to be completed when assessing cervical injury. This is the most common way to diagnose the location and severity of the fracture. To reduce the use of C-spine scans results in negative findings for fractures, so there is no need to expose people to radiation and improve hospital time and visitation costs, some clinical decision support rules have been developed to help physicians weigh the options to scan patients with neck injuries. Among these are Canadian C-spine rules and NEXUS criteria for C-Spine imaging, both of which help make this decision from easily obtained information. Both of these rules are widely used in the emergency department and by paramedics.
Indication of operation
Indications for surgery to stabilize cervical fractures can be estimated from Subaxial Injury Classification (SLIC). In this system, a score of 3 or less indicates that conservative management is appropriate, a score of 5 or more indicates that surgery is required, and score 4 is vague. Scores are the sum of the 3 different categories: morphology, discs and ligaments, and neurology:
Treatment
Complete immobilization of the head and neck should be done as early as possible and before transferring the patient. Immobilization must remain in place until head and neck movement is proven safe. In the presence of severe head trauma, cervical fractures must be presumed to be unable to get out. Immobilization is essential to minimize or prevent further spinal cord injury. The only exception is when there is danger from external causes, such as being trapped in a burning building.
Non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, are contraindicated because they interfere with bone healing. Tylenol (acetaminophen) is a better choice. Patients with cervical fractures may be prescribed medications to control pain.
In the long run, physical therapy will be given to build strength in the neck muscles to improve stability and better protect the cervical spine.
Collar, traction and surgery can be used to immobilize and stabilize the neck after cervical fracture.
Cervical collar
Minor fractures can be immobilized with the cervical neck without the need for traction or surgery. A soft collar is quite flexible and least restrictive but can carry a higher risk of further neck damage in patients with osteoporosis. Can be used for minor injuries or after healing has allowed the neck to become more stable.
Various rigid collars are also used, usually consisting of bi-valved plastic shells secured with Velcro straps and detachable liner liners. The most commonly prescribed are Aspen, Malibu, Miami J, and Philadelphia coats. All of these can be used with additional pieces of head and chest extensions to improve stability.
Rigid binding
Rigid braces that support the head and chest are also determined. Examples include Sterno-Occipital Immobilization Device (SOMI), Lerman Minerva and Yale types. Special patients, such as very young children or uncooperative adults, sometimes still can not move in medical plaster from a cast of paris, such as the Minerva cast.
Traction
Traction can be applied with a free load on a Hello type pulley or buffer. Brace Halo is the most rigid cervical brace, used when limiting motion to a very important minimum, especially with unstable cervical fractures. It can provide stability and support during the time (usually 8-12 weeks) required for the cervical bone to heal.
Surgery
Surgery may be needed to stabilize the neck and reduce the pressure on the spinal cord. Various operations are available depending on the injury. Surgery to remove damaged intervertebral discs can be done to reduce the pressure on the spinal cord. The disc is a cushion between the spine. Once the disk is removed, the spine can coalesce to provide stability. Metal plates, screws, or cables may be needed to hold the spine or pieces in place.
See also
- Brown-SÃÆ' Â © quard syndrome
- Cervical dislocation
- Internal clipping
- spinal cord injury
References
External links
- Health Information of Brigham And Women's Hospital - Neck Fracture. 9/12/2006.
- Cervical Fracture - DynoMed.com
- Van Waes OJ; et al. (Jan 2012). "Management of penetrating neck injury". J.Br J Surg . 99 (Suppl 1): 149-54. doi: 10.1002/bjs.7733. PMID 22441870. Ã,
- The pamphlets contain information that uses Halo Brace
Source of the article : Wikipedia
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